Individual
LAUREN MARIE MANCILLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8700 MONTANA AVE, EL PASO, TX 79925-1221
(915) 771-8523
(915) 771-8046
Mailing address
8700 MONTANA AVE, EL PASO, TX 79925-1221
(915) 771-8523
(915) 771-8046
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
37467
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149984001
—
TX
05
—
207164901
—
TX
Enumeration date
02/15/2013
Last updated
10/24/2018
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